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TUBERCULOSIS (TB)

What is Tuberculosis?

Tuberculosis (TB) is a disease caused by germs that are spread from person to person through the air. TB usually affects the lungs, but it can also affect other parts of the body, such as the brain, kidneys, or the spine. In most cases, TB is treatable, however, a person with TB can die if they do not get proper treatment.

What is multidrug-resistant tuberculosis?

Multidrug-resistant TB (MDR TB) is a form of the disease that is resistant to at least two of the best anti-TB drugs: isoniazid and rifampicin. These drugs are considered first-line drugs and are typically always used to treat a person suffering with TB. It is also spread through germs in the air.

What is extensively drug resistant tuberculosis?

Extensively drug resistant TB (XDR TB) is a relatively rare type of MDR TB, which is resistant to isoniazid, rifampicin, any fluoroquinolone and at least one of three injectable second-line drugs, such as amikacin, kanamycin or capreomycin.

Who should be concerned about XDR TB?

XDR TB is of particular concern to those with HIV or other conditions that can weaken the immune system, as these people have a higher risk of developing TB, as well as a greater risk of death once they have TB.

How does drug resistance happen?

Resistance to anti-TB drugs can occur when these drugs are misused or mismanaged, such as:

  • When patients do not complete their full course of treatment.
  • When healthcare providers prescribe the wrong treatment, dose, or length of time for taking the drugs.
  • When the supply of drugs is not available.
  • When the drugs are of poor quality.

Who is at risk for getting MDR TB?

Drug resistance is more common in people who:

  • Do not take their TB medicine regularly.
  • Do not take their TB medicine as prescribed by their doctor or nurse.
  • Develop active TB disease again, after having taken TB medicine in the past.
  • Come from areas of the world where drug-resistant TB is common.
  • Have spent time with someone known to have drug-resistant TB disease.

How to protect against MDR TB?

In order to prevent the spread of MDR TB, the following steps should be taken:

  • All medications should be taken exactly as prescribed by a healthcare provider.
  • No dose should be missed and treatment should not be stopped early.
  • A patient should inform their healthcare provider if they are having trouble taking the medications.
  • If a patient plans to travel, they should talk to their healthcare provider and make sure they have enough medicine to last while away.
  • Avoid exposure to known MDR TB patients in closed or crowded places such as hospitals, prisons or homeless shelters. Those working in hospitals or healthcare settings where TB patients are likely to be treated should consult infection control or occupational health experts and ask about administrative and environmental procedures for preventing exposure to TB. Once those procedures are implemented, additional measures could include using personal respiratory protective devices.

Exposure to TB: What to do

Any individual who believes they may have been exposed to TB, should take the following steps:

  • Contact a doctor or local health department to request a TB skin test or special TB blood test.
  • Explain to the doctor or nurse how and when the exposure occurred.
  • Follow the prescribed medical care.

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